Caspi Avshalom, Houts Renate M, Belsky Daniel W, Harrington Honalee, Hogan Sean, Ramrakha Sandhya, Poulton Richie, Moffitt Terrie E
Department of Psychology & Neuroscience, Duke University, Durham, NC, USA.
Department of Psychiatry & Behavioural Sciences, Duke University School of Medicine, Durham, NC, USA.
Nat Hum Behav. 2016;1. doi: 10.1038/s41562-016-0005. Epub 2016 Dec 12.
Policy-makers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run, bringing return on investment. How much return can be expected depends, partly, on how strongly childhood risks forecast adult outcomes. But there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade Dunedin birth-cohort study to test child-to-adult prediction in a different way, by using a population-segmentation approach. A segment comprising one-fifth of the cohort accounted for 36% of the cohort's injury insurance-claims; 40% of excess obese-kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless childrearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor age-three brain health, predicted this segment with large effect sizes. Early-years interventions effective with this population segment could yield very large returns on investment.
政策制定者对早期干预措施改善儿童期风险很感兴趣。他们希望从长远来看能改善成人的状况，带来投资回报。预期能获得多少回报部分取决于儿童期风险对成人状况的预测力度。但对于儿童期是否决定成年期存在分歧。我们将多个全国性行政数据库和电子病历与长达四十年的达尼丁出生队列研究相结合，采用人群细分方法以不同方式测试从儿童到成人的预测情况。该队列中五分之一的人群占了队列中36%的伤害保险索赔；40%的超重千克数；54%的吸烟量；57%的住院天数；66%的福利津贴；77%的单亲育儿情况；78%的处方药配给量；以及81%的刑事定罪。包括三岁时脑健康状况不佳在内的儿童期风险对这部分人群有很大的预测效应量。对这部分人群有效的早期干预措施可能会带来非常高的投资回报。
